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Teaching at the Bedside Using CHF as the Model
Teaching at the Bedside Using CHF as the Model

... devices or surgery. ...
Interpreting the ECG of a Patient with a Pacemaker - e
Interpreting the ECG of a Patient with a Pacemaker - e

... A PA student asks for help interpreting an ECG (Figure 3), saying that it does not look right. You take him through the step-by-step process for evaluating ECGs. (1) Is the rhythm regular? Use your calipers and march out the QRS complexes. It is a regular rhythm. (2) Now look at the heart rate.   Me ...
VITALITY DS EL ICD Patient Spec Sheet
VITALITY DS EL ICD Patient Spec Sheet

... certain steroid allergies. Procedure risks include infection, tissue damage, and kidney failure. Patients who should not receive this device include: patients whose ventricular rhythm disturbances have a reversible or temporary cause and patients with certain types of atrial rhythm disturbances. Pro ...
Electrocardiographic Monitoring During Cardiac
Electrocardiographic Monitoring During Cardiac

... monitoring needed for low-, intermediate-, or highrisk patients enrolled in cardiac rehabilitation.2 Instead, this decision is left up to the judgment of the cardiac rehabilitation staff who are encouraged to progress patients to less intensive monitoring when judged clinically stable and responsive ...
constrictive pericarditis
constrictive pericarditis

... The three most common causes of tamponade are neoplastic disease, idiopathic pericarditis, and renal failure  Bleeding into the pericardial space after cardiac operations, trauma, and treatment of patients with acute pericarditis with anticoagulants ...
Background Information
Background Information

... • This study represents initial testing of a handheld, battery-powered device using finger PPG during the Valsalva maneuver for assessing left ventricular filling pressure noninvasively. • The output measure of the device, Pulse Amplitude Ratio (PAR), correlated well with LVEDP obtained invasively b ...
Ischemic Mitral Regurgitation and Risk of Heart Failure After
Ischemic Mitral Regurgitation and Risk of Heart Failure After

... Interaction between the degree of ischemic mitral regurgitation and left ventricular ejection fraction. A, Event rates for the combined end point of heart failure (HF) and death according to left ventricular ejection fraction (LVEF) and the degree of ischemic mitral regurgitation (MR). B, Adjusted h ...
Exercise and Heart Failure. Relation of the Severity of the Disease to
Exercise and Heart Failure. Relation of the Severity of the Disease to

... timate or overestimate the guidelines for physical activity for healthy or ill individuals. When the values of the maximum heart rate in the groups of patients in functional classes I, II, and III were compared, we observed significant differences. For the values of heart rate in the anaerobic thres ...
Rate control was more cost-effective than rhythm
Rate control was more cost-effective than rhythm

... in the rate-control group. Given the neutral intention-to-treat differences for mortality and health-related quality of life (QOL) (2), the well-done study by Hagens and colleagues assessed costs in a “straightup” comparison without the need to adjust costs per QOL improvement. As seen in a similar ...
Cardiac Arrythmias
Cardiac Arrythmias

... • Varying amplitudes of the QRS. • It can be produced by afterdepolarizations (triggered activity). • Particularly in prolonged QT interval. • Occur with some drugs (quinidine), electrolite disturbances, and congenital prolongation of the QT interval. ...
Left Bundle Branch Block Under General Anaesthesia in an Athlete`s
Left Bundle Branch Block Under General Anaesthesia in an Athlete`s

... Physiological LVH or "athlete's heart" is the normal response to healthy exercise or pregnancy which results in an increase in the heart's muscle mass and pumping ability. Trained athletes (Rowers, cyclists, and cross-country skiers) have hearts that have left ventricular mass up to 60% greater than ...
Cardiology Consult - Upstate Medical University
Cardiology Consult - Upstate Medical University

... The primary learning process during this rotation comes from direct patient care. This involves being involved at the initial evaluation until the consult service “signs-off.” It is an opportunity for residents to improve their skill at doing histories and physicals and develop management plans for ...
26 Humeral and intracardiac mechanism of heart` regulation
26 Humeral and intracardiac mechanism of heart` regulation

... decreasing O² supply and other nutrients. Therefore rate of formation vasodilator substances (CO², lactic acid, adenosine, histamine, K+ and H+) rises. When decreasing both blood flow and oxygen supply smooth muscle in precapillary sphincter dilate, and blood flow increases.  Moderate increasing te ...
Heart Failure - Intermountain Healthcare
Heart Failure - Intermountain Healthcare

... MAWDS Self-Care Diary: Encourage your patients to use the MAWDS Self-Care Diary to record their daily weight and symptoms, and keep track of their medications and appointments. Reviewing the diary at every office visit promotes a partnership between you and your patient, and may help you better coor ...
عرض تقديمي من PowerPoint
عرض تقديمي من PowerPoint

...  Those pacemakers which generate action potentials at the highest frequency, dominate the rhythm, as the refractory period of heart muscle is such that the other pacemakers are ineffective unless the conduction of the main pacemaker signal is blocked.  The rate of pacemaker depolarization, and the ...
To Stent or Not To Stent: Focusing on the ISCHEMIA Trial to
To Stent or Not To Stent: Focusing on the ISCHEMIA Trial to

... ISCHEMIA is an international, randomized, controlled study, with a target enrollment of about 8000 patients with at least moderate ischemia on stress imaging and left ventricular ejection fraction of at least 35%.4 This trial overcomes the limitations of previous trials by randomizing patients to ei ...
Anesthesia-Related Cardiac Arrest in Children with Heart Disease
Anesthesia-Related Cardiac Arrest in Children with Heart Disease

The Electrical Impulses of the Heart*
The Electrical Impulses of the Heart*

... within your heart muscle • The electrical activity can be recorded by an electrocardiogram (aka EKG or ECG) ...
CPD-EE 2014 200x150.indd   1 13/11/2014   14:07
CPD-EE 2014 200x150.indd 1 13/11/2014 14:07

... Visit Abbott booth for more information Valves repaired. Lives improved. Abbott Vascular International BVBA, Park Lane, Culliganlaan 2B, B-1831 Diegem, Belgium, Tel: 32.2.714.14.11. Product is subject to prior training requirement as per the Instruction for Use. Prior to use, it is important to read ...
ACC/AHA/ESC AF Guidelines, 2006 Symptomatic Atrial Fibrillation!!
ACC/AHA/ESC AF Guidelines, 2006 Symptomatic Atrial Fibrillation!!

... ACC/AHA/ESC guidelines prepared over two years: 12 committee members, 4 European, 4 North American electrophysiologists. Updated 2006 ...
Heart Notes
Heart Notes

... The myocardium is drained by several cardiac veins which empty into an enlarged vessel on the backside of the heart called the coronary sinus, which empties into the rt. atrium. When the heart beats rapidly myocardium may not receive enough blood (blood is only able to flow during relaxation periods ...
Heart Ch 18-PPT-STUDENT-2015
Heart Ch 18-PPT-STUDENT-2015

...   Vagus nerve (= Vagal Tone)  Stroke volume controlled by EDV ...
Managing Atrial Fibrillation - Scioto County Medical Society
Managing Atrial Fibrillation - Scioto County Medical Society

... Overall, RAS inhibition reduced the odds ratio for AF by 33% (p < 0.00001), but there was substantial heterogeneity among trials. In primary prevention: RAS inhibition was effective in patients with heart failure and those with hypertension and left ventricular hypertrophy In secondary prevention: R ...
Rheumatic Heart Disease
Rheumatic Heart Disease

... "open-heart" surgical procedure in which a number of incisions are placed in the atria to create lines of block so that the multiple reentrant circuits cannot develop. Several catheter ablation techniques have also been developed but currently these are regarded as investigational since the safety a ...
Clinical characteristics, treatment and prognosis of patients with
Clinical characteristics, treatment and prognosis of patients with

... intensive care, cardiac surgery, vascular surgery, transplantology and diabetology. Depending on clinical indications, the diagnostic and therapeutic process of acute severe HF also involved the use of various forms of mechanical heart support and heart transplantation. Data on patient mortality aft ...
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Cardiac contractility modulation



Cardiac contractility modulation (CCM) is a treatment for patients with moderate to severe left ventricular systolic heart failure (NYHA class II–IV). The short- and long-term use of this therapy enhances both the strength of ventricular contraction and the heart’s pumping capacity. The CCM mechanism is based on stimulation of the cardiac muscle by non-excitatory electrical signals (NES). CCM treatment is delivered by a pacemaker-like device that applies the NES, adjusted to and synchronized with the electrical action in the cardiac cycle.In CCM therapy, electrical stimulation is applied to the cardiac muscle during the absolute refractory period. In this phase of the cardiac cycle, electrical signals cannot trigger new cardiac muscle contractions, hence this type of stimulation is known as a non-excitatory stimulation. However, the electrical CCM signals increase the influx of calcium ions into the cardiac muscle cells (cardiomyocytes). In contrast to other electrical stimulation treatments for heart failure, such as pacemaker therapy or implantable cardioverter defibrillators (ICD), CCM does not affect the cardiac rhythm directly. Rather, the aim is to enhance the heart’s natural contraction (the native cardiac contractility) sustainably over long periods of time. Furthermore, unlike most interventions that increase cardiac contractility, CCM is not associated with an unfavorable increase in oxygen demand by the heart (measured in terms of Myocardial Oxygen Consumption or MVO2). This may be explained by the beneficial effect CCM has in improving cardiac efficiency. A meta-analysis in 2014 and an overview of device-based treatment options in heart failure in 2013 concluded that CCM treatment is safe, that it is generally beneficial to patients and that CCM treatment increases the exercise tolerance (ET) and quality of life (QoL) of patients. Furthermore, preliminary long-term survival data shows that CCM is associated with lower long-term mortality in heart failure patients when compared with expected rates among similar patients not treated with CCM.
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